ECTS - EUROPEAN CREDIT TRANSFER SYSTEM
STUDENT APPLICATION FORM		
(Photograph)
ACADEMIC YEAR 	2021 /  2022
FIELD OF STUDY

This application should be completed in BLACK in order to be easily copied and/or telefaxed.

SENDING INSTITUTION
Name and full address: 	UNIVERSITY OF SZEGED  		Int. code: HU SZEGED01 
				H-6720 SZEGED, DUGONICS TÉR 13.
Departmental coordinator - name, telephone and telefax numbers, e-mail box 
................................................................................................................................................. .................................................................................................................................................
Institutional coordinator - name, telephone, and telefax numbers, e-mail box 
				GABRIELLA BALOG MOLNÁR
		TEL/FAX: +36-62-544-833 	E-mail: 

STUDENT’S PERSONAL DATA (to be completed by the student applying)

Family name: ..................................................	
First name(s): .................................................	
Date of birth: .................................................		
Sex: ............ Nationality: ...............................		
Place of birth: ................................................		
Current address: ............................................
.......................................................................
.......................................................................	Permanent address (if different): .....................
.......................................................................
.......................................................................	
Current address is valid until: .........................		
Tel: ................................................................	Tel: ................................................................	
	
E-mail address: ..............................................................……………………………………….	

LIST OF INSTITUTIONS WHICH WILL RECEIVE THIS APPLICATION FORM 
(in order of preference):
Institution	Country	Period of study
from       to	Duration of stay (months)	No of expected ECTS credits	

1. ...............................
2. ...............................
3. ...............................	
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.................................	
.................................	
..........................................................................................	
..........................................................................................	

Name of student: ......................................................................................................................

Sending institution: 						Country:
UNIVERSITY OF SZEGED 					HUNGARY
Int. code: HU SZEGED01	

Briefly state the reasons why you wish to study abroad?

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LANGUAGE COMPETENCE
Mother tongue: ………… Language of instruction at home institution (if different): ………….	
Other languages	I am currently studying this language	I have sufficient knowledge to follow lectures	I would have sufficient knowledge to follow lectures if I had some extra preparation	
	yes	no	yes	no	yes	no	

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WORK EXPERIENCE RELATED TO CURRENT STUDY (if relevant)
Type of work experience

……………………...
……………………...
	Firm/organisation

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	Dates

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	Country

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PREVIOUS AND CURRENT STUDY

Diploma/degree for which you are currently studying: …………………………………………………..
Number of  higher education study years prior to departure abroad: …………………………………….
Have you already been studying abroad?                  Yes            No 
If Yes, when? at which institution? ………………………………………………………………………
The attached Transcript of records includes full details of previous and current higher education study. Details not known at the time of application will be provided at a later stage.	

RECEIVING INSTITUTION
Hereby we acknowledge 			 the receipt of the application, 
					 the proposed learning agreement and 
					 the candidate’s Transcript of records.

The above-mentioned student is			 provisionally accepted at our institution
 not accepted at our institution

Departmental coordinator’s signature                 Institutional coordinator’s signature     

……………………………………………        ……………………………………………………….
Date: …………………………………….. 	Date:…………………………………………………